Monday, June 27, 2016

Oh there is so much to say and so little time.I'm sending you to two different sites today:My post on Guns & Mental Illness over on Clinical Psychiatry News. It never fails to amaze me that suspected terrorists get due process before losing their constitutional rights to own a gun, but law-abiding people with psychiatric disorders have no such rights. Please do read my article and share you own thoughts here.And the famous Spotlight group of the Boston Globe is taking on the failures of the mental health system in Massachusetts. They start with an article about mentally ill people who murder their families. Oy. The article was good, and access to care is an enormous problem. And unfortunately, the
sensationalism is stigmatizing at a time when we are trying to get rid
stigma so that people will not hesitate to seek the help they need. But
if you show up for help, you may be forced into treatments you don't
want, lose your gun or your career, and be looked at as a potential mass
murderer and family killer. And at least some of the people with
mental illnesses kill family members for reasons unrelated to their
mental illness -- like others who kill, they are angry &/or
intoxicated but not necessarily psychotic. Most end up in prison, found
to be responsible for their acts. And some are actively in treatment
at the time they commit violent acts, so psychiatry may not be
everyone's answer. There is a facebook group for those who want to comment, so I'll send you there for a rich conversation with input from everyone with an opinion.

Monday, June 13, 2016

No, not again. I looked at my Twitter feed and learned about yet another mass shooting. I can't even imagine what it's like to feel the kind of fear the people in that nightclub felt, to die in such a horrible way, to live with the aftermath, or to be a family member and know that someone viciously targeted my loved one and purposely inflicted such horror on them. My heart goes out to the victims and their loved ones, and I'm so sorry they are going through this unnecessary tragedy.

I heard on the news that the gunman's ex-wife said he was physically abusive and mentally unwell, but I don't know if there was a clinical diagnosis or simply the observation that he was an angry and violent person. She also has not seen him in 7 years, and if he mentally ill, he has been able to hide that fact from his employer. The press reported that he was steadily employed for nearly nine years and his employer, a security firm, did not see this coming. I say this only because the initial news reports seem to imply that the gunman was a radical extremist, twice investigated by the FBI as a terrorism suspect, he obtained a military-grade assault weapon legally, and he called 911 during the event and pledged his support to a terrorist group. What does this have to do with psychiatry? If the facts are as they now appear (and they may change or be slanted by the press), but the answer is Nothing. The Orlando terror/hate mass murder, as currently reported, does not seem to be about something in the realm of psychiatrists. People who sign on may be angry --I believe it takes anger to kill innocent people -- but so far, we're not hearing that there is something here for psychiatrists to treat, or that if only he'd sought help, this never would have happened. But these days, we talk about mass murders as defined by the number of victims in a public place, and terrorists get lumped together with those who commit such acts because of delusional states.

And just in case you missed it, an Indiana man was arrested in LA with a car full of assault weapons and explosives, perhaps enroute to a Gay Pride parade, on that same day. The horror of the day could have been even worse than it was.

It's no secret that I believe gun control measures would help. I don't believe they would prevent all the deaths that guns cause, and there are certainly other ways that terrorists have of killing people. We saw that on 9/11 and we saw that with the Boston Marathon bombing. But I find it strange that we allow for the manufacture of firearms that enable one person to kill dozens of people within minutes, we allow for the easy access of these weaponsby civilians (even a previous terror suspect with a history of domestic violence) and then we're surprised when people buy these weapons and use them for exactly what they were made to do: kill lots of people quickly. Should we ban them? Of course. They are not a household item that anyone needs, and while we will still have terrorism and hate crimes, there is no reason to hand terrorists or haters the easy means to their evil end.

It's funny, because after the fact, there is blame, finger-pointing, and questions of who missed what and how could we not have known. Who should have seen it coming? Yet know one says, when someone buys an assault weapon with lots of ammunition, maybe a flag should be raised. Maybe someone should go ask this person why they need such a weapon, check up on their history, look at whether the weapon is being kept securely and whether someone else in the household who should not have a gun might have access to it. Or maybe we simply shouldn't have assault weapons as legal machines to be owned by any citizen who wants one, short of felons.

No, I'm not suffering the way the victims and their families are, but each one of these events takes just a little out of all of us. Whether it's a an act of terror, an act of hate, an act of violence perpetrated by someone who is very ill, or routine gang violence that we see in our city everyday, it touches us all. I hope this does not leave you afraid, because if it does, the terrorists win.

Saturday, June 04, 2016

My post for today is a review of Peter Kramer's new book over on Clinical Psychiatry News. You may remember him from Listening to Prozac, and he's back now with more on the science that supports the use of anti-depressants.